Prediction of first episode of panic attack among white‐collar workers

Studies on gene-environment interactions in mental disorders are characterized by powerful genetic techniques and well defined "candidate genes," whereas a definition of "candidate stressors," in most cases assessed in the form of life events (LEs), is inconsistent or not even provided. This review addresses this problem, with particular attention to the clinical phenotype of panic disorder (PD), by providing an overview and critical discussion for which life events are known to contribute to the etiology of the disease and how they may be conceptualized. There is converging evidence for a significant impact of cumulative as well as specific life events, such as threat, interpersonal and health-related events in adulthood, and abuse or loss/separation experiences in childhood, respectively, on the pathogenesis of panic disorder with some overlapping effect across the anxiety disorder spectrum as well as on comorbid major depression. Besides genetic vulnerability factors, personality and behavioral characteristics, such as anxiety sensitivity, neuroticism, and cognitive appraisal might moderate the influence of LEs on the development of panic disorder. The present state of knowledge regarding the specification and conceptualization of LEs in PD within a more complex multifactorial model, involving mediating and moderating factors in between genes and the clinical phenotype, is hoped to aid in informing future gene-environment interaction studies in panic disorder.

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“…Watanabe et al [23] 1,602 subjects (divided into those experiencing a panic attack within the following year and those without panic)…”

Section: Healthy Controlsmentioning

confidence: 99%

Life events in panic disorder-an update on “candidate stressors”

et al. 2010

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“…Basically, the literature is fairly consistent in reporting an excess of negative (exit) events in the 6–12 months preceding depression [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18], schizophrenia [19,20,21,22,23] and anxiety disorders [24,25,26,27,28,29,30,31,32,33]. …”

Section: Introductionmentioning

confidence: 95%

Epidemiology of Life Events: Life Events and Psychiatric Disorders in the Sesto Fiorentino Study

Faravelli

Catena

Scarpato

et al. 2007

Psychother Psychosom

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Background: Although life events have been consistently reported as precipitating factors for most psychiatric disorders, there is no comprehensive investigation of the relationship between severe life events and psychiatric disorders in the general population. Methods: This is a community-based study of psychiatric disorders among a cohort representative of adults in an Italian town. A total of 2,363 subjects out of 2,500 selected to be representative of the population living in Sesto Fiorentino, central Italy, were interviewed by their own general practitioner using the Mini International Neuropsychiatric Interview. Of the 613 subjects, 609 who resulted positive for any psychiatric disorders and 123 out of a random sample of 130 negatives were re-interviewed by the psychiatrists using the Florence Psychiatric Interview. The Florence Psychiatric Interview was used to explore each distinct psychiatric episode. Life events were recorded in detail by a specific interview. Results: During the year prior to the onset of the first psychiatric disorder, 35.8% of cases suffered from at least a severe event, compared with 12.2% of non-cases during a comparable period (OR = 4.0, 95% CI = 2.3–7.1). The excess of life events occurred for almost all the diagnostic categories. The same results were reproduced even when only the ‘independent’ life events were considered. The distribution of the events through the 12 months taken into account showed an even distribution of events among non-cases, whereas there was a clear accumulation in the last 3 months prior to the onset of the pathology in the cases. Conclusions: Life stress is one of the main precipitating factors of psychopathology.

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“…[11][12][13][14] Moreover, a longitudinal study recently identified stress as a prospective predictor of first panic attacks among white collar workers. 15 Less attention has been given to the role of stress in maintaining PD or leading to relapse. Life stress is associated with greater symptom severity in patients with PD, 16 and in one study chronic stress was associated with poorer long term outcome from CBT for agoraphobia.…”

Section: Introductionmentioning

confidence: 99%

Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder

Heldt

Kipper

Blaya

et al. 2010

Rev. Bras. Psiquiatr.

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OBJECTIVE: To investigate predictors of relapse two years after a brief cognitive-behavior group therapy in patients with panic disorder who had failed to respond to pharmacologic treatment. METHOD: A total of 56 patients with panic disorder were followed who had met remission criteria at 1 year evaluation after 12 sessions of cognitive-behavior group therapy. Demographic and clinical features and life stressors were investigated as predictors of relapse. RESULTS: At the 2 year assessment, 39 (70%) patients maintained remission status and use of medication was reduced significantly, such that 36 (64%) patients were not undergoing any psychiatric treatment. Among all independent variables investigated, only "conflict" as a stressful life event, RR = 3.20 (CI95% 1.60; 7.20 - p = 0.001), and the severity or residual anxiety symptoms, RR = 3.60 for each scale point (CI95% 1.02; 1.08 - p < 0.001), emerged as nonredundant predictors. CONCLUSION: In spite of the high treatment gains across two years of follow-up, clinicians should pay attention to stress management and to the role of residual symptoms during this period. Results were discussed in the context of treatment cost-efficacy and potential strategies to prolong treatment gains from cognitive-behavior group therapy.

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Prediction of first episode of panic attack among white‐collar workers

Cited by 27 publications

References 41 publications

Life events in panic disorder-an update on “candidate stressors”

Life events in panic disorder-an update on “candidate stressors”

Epidemiology of Life Events: Life Events and Psychiatric Disorders in the Sesto Fiorentino Study

Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder

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